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Gynecol Oncol. 2017 Apr;145(1):148-153. doi: 10.1016/j.ygyno.2017.02.006. Epub 2017 Feb 12.

Long-term ototoxicity in women after cisplatin treatment for ovarian germ cell cancer.

Author information

1
Department of Otolaryngology, Head and Neck Surgery, Rikshospitalet, Oslo University Hospital, Norway.
2
Department of Gynecological Oncology, Radiumhospitalet, Oslo University Hospital, Norway.
3
National Resource Center for Late Effects after Cancer Treatment, Radiumhospitalet, Oslo University Hospital, Norway. Electronic address: sopfos@ous-hf.no.
4
Department of Health Science and Biostatistics, Høgskolen i Oslo og Akershus, Norway.
5
Department of Clinical Pharmacology, St Olav University Hospital, Trondheim, Norway.

Abstract

OBJECTIVE:

Evaluate long-term cisplatin-induced ototoxicity in women treated for malignant ovarian germ cell tumors (MOGCT).

METHODS:

Seventy-four women treated for MOGCT in Norway (1980-2009) were analyzed: 41 had received cisplatin-based chemotherapy (CBCT) ("Cases") and 33 had no CBCT ("Controls"). Median follow-up was 15years. Hearing was assessed by pure tone audiometry and by the SCIN questionnaire. Air conduction thresholds were reported as absolute hearing thresholds and age-adjusted thresholds. Absolute and age-adjusted hearing loss were defined as thresholds of >20dB at any frequency. Tinnitus was evaluated using the Tinnitus Handicap Inventory. Serum Platinum Concentration (SPC) was determined.

RESULTS:

Absolute hearing loss was identified in 21 Cases (51%) and 24 Controls (73%). After adjusting for age, only 9 Cases (22%) and 5 Controls (15%) remained. Age-adjusted hearing thresholds at 4, 6 and 8kHz were slightly but significantly higher in Cases compared to Controls. Subjective hearing loss was reported by 27% of Cases and 21% of Controls, who were significantly older. Elevated SPC values were detected up to 20years after CBCT, but SPC did not correlate significantly with age-adjusted hearing loss. The rate of tinnitus was similar in Cases and Controls.

CONCLUSION:

Long-term MOGCT survivors treated with CBCT have small but significant reductions in age-adjusted hearing thresholds at 4, 6 and 8kHz versus Controls. Approximately one in four women experienced subjective hearing loss. To avoid overestimation of clinically relevant cisplatin-induced ototoxicity, absolute hearing thresholds should be age-adjusted and compared to an age-matched control group.

PMID:
28202195
DOI:
10.1016/j.ygyno.2017.02.006
[Indexed for MEDLINE]

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